I’ve dealt with pain in numerous areas over the years (chronic and otherwise), and am wondering if anyone has found any evidence-based finger/grip strengthening exercises that help with finger pain/ulnar nerve irritation/etc. Anecdotes are fine here too. I’ve had what feels like “trigger finger”, RSI, tendonitis and ulnar nerve irritation over the use. Not playing that much, probably 30 min a day, but I use my hands for work. I generally find pinky stretches and sustained index finger use (think chords held low on the fretboard) to be the most problematic.
As an aside, I’d like to generally divulge my perspective on pain and injury, based on what I’ve learned over the years, to avoid confusion, and also because I haven’t found a lot through searches covering this more extensively. Perhaps this will be informative, perhaps redundant.
Many of these may seem unintuitive or contrary to popular advice from clinicians/MDs, but this is where pain science has led:
If you want a much better-written version, simply go here (no affiliation with the site, for the record):
Pain =/= “Injury”. Injury is difficult to define, and pain can be nebulous. Take this explanation with a grain of salt as I’m not a pain scientist, but the reason this distinction is important is because while we do have nociceptors that send danger signals to the brain when “damage” or “threat” occurs to a specific region, the ongoing loop from the brain is what causes “pain”. The most obvious example here is a minor cut on your skin, which generally has a fairly linear relationship with pain. When the cut heals, the pain stops.
This isn’t always the case with tendonopathy, or most especially something like non-specific back pain. Often the “pain” loop is a danger-based one. Sometimes a “tweak” is simply exceeding load, and your brain is telling you to back off. Sometimes a “tweak” is completely unrelated, and it’s important to get things to “calm down” as fast as possible. This generally involves slightly backing off intensity of a particular activity, while most importantly continually moving. The reality is that no common overuse “injury” takes ten years, or even one year, to heal. There are much faster ways to get pain free.
Sometimes the issue is in-between, and this is generally the case when other symptoms like swelling is involved.
The most telling evidence of this is the lack of correlation between adverse finding in imaging studies and pain. It’s nearly 50/50 or similar for disc herniations, joint “degeneration”, ligament pathology, etc. There’s honestly relatively little point to doing imaging for most commonly experienced weightroom or similar pain. Phantom limb pain is also a fantastic example.
Predictors of pain are broad, and may include a) exceeding load tolerance (combination of intensity/volume), b) sleep disruptions/stress (very consistently found to correlate with pain in scientific literature), c) expectation/fear/etc. “Bad form” is interestingly not a good predictor of injury in weightlifting. This is a bit more difficult to pin down with music, because tension, end-range stretches or similar can be equated to “load management” and can greatly increase or decrease overall strain, so I do think posture and playing relaxed are very important aspects of musical practice.
Our bodies are extremely adaptable. This includes tendons, ligaments, bones, etc. For everyone that sincerely believes deadlifts are inherently “bad for you”, I can show multiple examples of people doing ridiculous, lumbar-deep-flexing, silly “creative” lifts, who do so consistently without pain or injury. Again comes down to load management over time and progressive adaptation. I believe this is the case with music as well, though generally surveying seems to indicate there are common limits. At age 30-something I’m not really interested in trying to play 7h a day, and most symphony string players I know will pop Advil or similar during long concertos or symphonies, so there does seem to be difficult ranges or degrees. Lots of individual variation as well, but the principle applies.
TL;DR: Any exercises recommended for finger pain while playing? Generally pinky pain/ulnar nerve irritation with stretchier-chords, and index finger irritation irritation when chording. Not a lot of tolerance at this point, only playing 30-45 mins a few times a week, so obvious deconditioned. Would like to be able to play 1h or so a day along with some piano an hour a day as well.